Drug interactions
Influenza virus vaccine quadrivalent + Rituximab
Severity: Moderate
Influenza virus vaccine quadrivalent and Rituximab: moderate interaction.
Last updated
For healthcare professionals — reference only. This page is a brief summary, not medical advice and not a substitute for official labeling or clinical judgement. Always verify before prescribing or dispensing.
Summary
Rituximab greatly diminishes the antibody response to inactivated quadrivalent influenza vaccine. Patients may stay susceptible to influenza despite being immunized.
What this interaction means in plain words
Influenza virus vaccine quadrivalent and Rituximab can affect each other. The combination is often manageable, but it may need a change of dose, a change of timing, or extra checks while both are taken.
Why it happens
Rituximab-mediated CD20-positive B-cell depletion impairs humoral vaccine responses.
What to do
Give the vaccine at least 4 weeks before a rituximab course when feasible. Still vaccinate patients already on therapy, but recognize the response may be poor and consider early antiviral treatment if influenza occurs.
What to ask your pharmacist
- Should I take them at different times of day?
- Does the dose of either medicine need to change?
- Is there anything I should avoid, such as alcohol or certain foods, while on both?
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Other interactions of Rituximab
Frequently asked questions
Can I take Influenza virus vaccine quadrivalent with Rituximab?
MediHelp rates the interaction as moderate. Influenza virus vaccine quadrivalent and Rituximab can affect each other. The combination is often manageable, but it may need a change of dose, a change of timing, or extra checks while both are taken. Rituximab greatly diminishes the antibody response to inactivated quadrivalent influenza vaccine. Patients may stay susceptible to influenza despite being immunized.
How serious is the interaction between Influenza virus vaccine quadrivalent and Rituximab?
MediHelp rates it moderate, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Give the vaccine at least 4 weeks before a rituximab course when feasible. Still vaccinate patients already on therapy, but recognize the response may be poor and consider early antiviral treatment if influenza occurs.
What other medicines interact with Rituximab?
MediHelp also lists interactions of Rituximab with, for example, Adenovirus types 4 and 7 live, Baricitinib, Certolizumab pegol. The full list is on the Rituximab page.
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